47011 research outputs found
Sort by
Feasibility, reach, and acceptability of social prescribing in the emergency department
No full textBackgroundSocial prescribing (SP) connects individuals with community resources to address practical, social and emotional needs affecting health. While predominantly located in primary care, SP models have been introduced in some Emergency Departments (EDs). This study evaluated the feasibility, reach and acceptability of an ED-based SP pilot in the United Kingdom.MethodsFeasibility and reach were assessed through a retrospective review of anonymised patient trackers and clinical records. Acceptability was evaluated via a staff survey exploring knowledge, attitudes and referral practices.ResultsOver 14 months Social Prescribers supported 1,057 ED patients, with mental wellbeing being the most common referral reason. Patients were signposted or referred to over 200 different community organisations. The programme was valued by ED staff, who recognised its potential to improve patient health and wellbeing. Reported barriers included limited awareness of the out-of-hours referral pathway.DiscussionThis is the first published evaluation of an ED-based SP programme, building upon existing conceptual models and qualitative studies that have explored its potential. The findings demonstrate that the model is both feasible and acceptable to staff, while effectively reaching patients with a broad range of health and social needs. Further research is needed to explore long-term impacts on patient outcomes and broader system-wide benefits
Web-Based Interactive Training for Managers (Managing Minds at Work) to Promote Mental Health at Work: Pilot Feasibility Cluster Randomized Controlled Trial
Get PDFBackground:Line managers play a key role in preventing poor mental health but often lack necessary skills and knowledge. Existing interventions typically focus on mental health awareness rather than practical skills. The evidence-based Managing Minds at Work (MMW) web-based training program was developed to address this gap by enhancing line managers’ confidence and competence in prevention.Objective:This study piloted the MMW intervention to assess its feasibility. Objectives included evaluating (1) uptake potential across small, medium, and large companies; (2) perceived suitability and effectiveness of the intervention; and (3) feasibility of outcome data collection methods.Methods:We conducted a 2-arm pilot cluster randomized controlled trial of a self-guided, web-based training intervention for line managers. Twenty-four organizations were randomly assigned to the MMW intervention or a 3-month waitlist. A total of 224 line managers completed baseline measures (intervention: n=141, 62.9%; control: n=83, 37.1%), along with 112 of their direct reports (intervention: n=74, 66.1%; control: n=38, 33.9%). Follow-up data were collected at 3 and 6 months. Semistructured interviews with line managers and stakeholders (n=20) explored experiences with the study and intervention, and qualitative data were analyzed thematically. Line managers also completed feedback forms after each of the 5 MMW modules.Results:The recruitment of organizations and line managers exceeded targets, and retention rates of line managers were good at 3 months (161/224, 71.9%) but not at the 6-month follow-up (55/224, 24.6%). Feedback on the intervention was very positive, indicating that line managers and organizational stakeholders found the intervention acceptable, usable, and useful. We observed significant improvements with moderate to large effect sizes for all trial outcomes for line managers in the intervention arm from baseline to the 3-month follow-up. Line managers completed a variety of questionnaires, which showed increased scores for confidence in creating a mentally healthy workplace (intervention group: mean change 3.8, SD 3.2; control group: mean change 0.6, SD 3.2), mental health knowledge (intervention group: mean change 1.9, SD 3.0; control group: mean change 0.2, SD 2.9), psychological well-being (intervention group: mean change 3.6, SD 8.3; control group: mean change −0.7, SD 7.7), and mental health literacy at work (intervention group: mean change 11.8, SD 8.9; control group: mean change 0.8, SD 6.2). Collecting data from direct reports in both study arms was challenging, with results inconclusive regarding observed changes in trial outcomes. Time constraints and workload were commonly cited barriers to completion of the intervention.Conclusions:This pilot feasibility trial provides strong evidence for the usability and acceptability of the MMW digital training and the research design. MMW shows potential to improve line managers’ confidence and competencies in promoting mental health. The study also identified key considerations for future large-scale implementation and evaluation.Trial Registration:ClinicalTrials.gov NCT05154019; https://clinicaltrials.gov/study/NCT0515401
Regional profiling reveals a distinct glioblastoma infiltrative margin proteome
Get PDFIsocitrate dehydrogenase wild-type glioblastoma, a malignant brain tumour of glial origin, confers a poor prognosis with a median survival of 12 to 16 months from diagnosis. Glioblastomas are aggressive tumours that rapidly proliferate and diffusely infiltrate surrounding brain tissue. Current multimodal standard treatment is typically ineffective and despite gross total surgical resection, tumours recur with more aggressive sub-clonal populations of malignant cells. A defining characteristic of glioblastoma is its highly heterogeneous nature and acquirement of somatic mutations advantageous to tumour growth and suppression of apoptotic pathways. Pathogenesis of malignant brain tumours as well as its mode of transformation to a more aggressive subtype is still largely unknown. Although genomic studies have elucidated a plethora of genetic markers associated with glioblastoma subtypes, only a few have been utilised in a clinical setting. One of the emerging approaches to studying glioblastomas is by investigating how an active proteome contributes to its aggressive nature. Furthermore, through activation of specific pathways via post-translational modifications of proteins such as phosphorylation, glioblastomas create an intricate network of signalling pathways which favour tumour growth and proliferation. Here, we investigated the feasibility of diverse methodological approaches to describe abnormal protein signalling across distinct intra-tumour regions of primary glioblastoma tissue, including proliferative core, peripheral rim, and invasive margin. Whilst we observe a broadly comparable proteome relative to the human non-diseased brain, we identify cytoplasmic proteins α-trypsin, actin, apolipoprotein A1 and transthyretin which may putatively be associated with the GBM infiltrative tumour margin
Enhanced heat transfer of PCM-based heat sink augmented with plate-fins and hybrid nanoparticles for electronics cooling
No full textPassive cooling technologies based on phase change material (PCM) reveal as emerging technique for thermal management of electronic components effciently. Therefore, the current study explores the combined effect of hybrid nanoparticles (HNPs), plate- ns, and PCM integrated in a heat sink for both heating and cooling operation modes. As, PCM exhibits the lower thermal conductivity which makes it unfavourable for rapid heat transfer modes especially while solidification phase. Therefore, the novel incorporation of higher thermal conductive fins and hybrid nanoparticles with PCM are numerically studied to promote the heat transfer rate while melting and solidification phases. HNPs of graphene nanoplatelets (GNP)-copper (Cu) are dispersed in PCM of varying loading content (2%≤φ≤6%) to develop hybrid nanocomposite phase change material (HNcPCM). Similarly, the number of plate-fins are varied by changing their volume fraction (0%≤γ≤20%). Under a constant heat flux, the thermal performance is evaluated under transient conditions for both qualitative and quantitative aspects. Results exhibit the rapid enhancement in heat transfer rate during melting/solidification and a lower heat sink base temperature is revealed. A reduction in heat sink base temperature is reduced by 4.0% and 5.35% with 10% and 20%, respectively, compared to 0% without HNPs. However, this reduction is achieved of 0.63%, 1.10% and 1.5% with 2%, 4% and 6% of φ hybrid nanoparticles, respectively, with 10% compared to 0%. The heat storage/release capacity (Q) and heat storage/release density (q) exhibit the decreasing trend because of increase in total mass of HNcPCM-Fins. A reduction in Q and q is obtained of 24.18% and 23.1%, respectively, for 10% during melting phase in latent-heat state. The addition of plate-fins and GNP-Cu HNPs present a uniform melting/solidification phenomenon of HNcPCM inside the heat sink and a rapid melting/solidi cation rate and phase completion time are obtained, which understands the fluctuating operating modes. The higher enhancement in temperature response rate is obtained in case of plate-fins compared to the addition of GNP-Cu HNPs for both melting and solidi cation phases. The enhancement in heat transfer (Q´) and heat transfer density (q´) is obtained of 12.23% and 13.84% for 10%, respectively, during cooling phase compared compared to 0% in latent-heat state. The optimum volume fractions of GNP-Cu HNPs and plate-fins are found of 2% and 10%, respectively, for effective thermal management performance of a HNcPCM-Finned integrated heat sink system
It's not that Simple: An Objectivist Account of Spinoza on God's Essence
Get PDFA central objection to objectivist interpretations of Spinoza's theory of attributes is their alleged inconsistency with his commitment to the simplicity of God's essence. This paper offers a novel response to this objection. I begin by outlining two main arguments for the claim that, for Spinoza, God's essence must be simple: his alignment with a longstanding tradition that treats simplicity as a necessary divine property, and his endorsement of the principle that parts are by nature prior to their wholes. I then introduce a distinction, available within Spinoza's framework, between integral and metaphysical parts. I argue that while Spinoza is committed to the view that God's essence cannot have integral parts, he is not committed to denying it metaphysical parts. This reading not only addresses the simplicity objection but also clarifies Spinoza's definition of 'attribute' and strengthens the case for both structural and constitutive forms of objectivism
O90 Non-colorectal gastrointestinal cancer diagnoses within 1-year of symptomatic faecal immunochemical test (FIT): an English cohort study
No full textCommon inflammatory proteins linking frailty and area-level deprivation as key drivers of cardiovascular risk in women
Get PDFBackgroundChronic inflammation is linked to frailty and deprivation, both of which are comorbid with cardiovascular diseases (CVD). This study aims to identify inflammatory proteins associated with both socioeconomic deprivation and frailty, and assess their role in mediating cardiovascular risk in a large cohort with independent replication.MethodsWe included 2144 TwinsUK females aged 37–84 with concurrent measures of frailty (frailty index), index of multiple deprivation (IMD), cardiovascular risk (ASCVD score), and 74 proteins (Olink inflammation panel). A random forest model with SHapley Additive exPlanations identified shared proteomic markers of frailty and deprivation. Linear mixed models assessed associations between selected proteins, IMD, frailty, and ASCVD score. Findings were validated in 57 females from the Nottingham Osteoarthritis study. Mixed-effects Cox regression evaluated associations with 10-year ischemic heart disease risk, and mediation analysis assessed the role of proteins in linking IMD and frailty to ASCVD risk.ResultsWe identify ten pro-inflammatory proteins associated with both frailty and area-level social deprivation. Four of those (TNFSF14, HGF, CDCP1, and CCL11) are consistently positively correlated with ASCVD score in both two cohorts. CDCP1 is also associated with higher incident ischemic heart disease risk (HR [95%CI] = 1.82 [1.17, 2.85]). TNFSF14, HGF, and CDCP1 mediate the association between IMD and ASCVD, as well as between frailty and ASCVD.ConclusionsOur findings indicate that inflammatory proteins involved in cellular signalling, growth, and migration are associated with frailty, socioeconomic deprivation, and CVD risk, suggesting that these pathways mediate the impact of socioeconomic deprivation and ageing on CVD risk
Standards and Methods of Proof : An English Perspective on Della Torre’s Comparative Legal History
Get PDFThis Comment responds to Jacopo Della Torre's recent article advocating Taking the Evolution of the Standards of Proof for Criminal Conviction Seriously. Having summarised Della Torre's central thesis and clarified (and largely endorsed) his contextual approach to investigating the criminal standard of proof, I offer-from the perspective of an English common lawyer-some methodological caveats, conceptual reservations and minor textual corrections to Della Torre's illuminating comparative legal history
Reflections on the manifestation of attention-deficit hyperactivity disorder in girls from young adults with lived experiences: a qualitative study
Get PDFBackgroundAttention-deficit/hyperactivity disorder (ADHD) is more commonly missed or diagnosed later in females than in males. One explanation is that diagnostic criteria have been informed by research primarily based on male samples and may not adequately capture the female presentation of ADHD.AimsThis study used a qualitative approach to better understand female ADHD in childhood, from the perspective of young women and non-binary adults with ADHD.MethodTwelve young adults (10 women and 2 non-binary individuals assigned female at birth, aged 18–25 years) with ADHD were interviewed to describe their lived experiences of ADHD throughout childhood. Interviews were transcribed verbatim and qualitatively analysed using the framework method, a codebook approach to thematic analysis.ResultsParticipants reported experiencing a range of ADHD symptoms, some of which are not included in current diagnostic criteria. Four core themes were identified: (a) socially oriented and internalised symptoms, (b) social impacts, (c) masking and compensation and (d) the importance of context. Theme one describes how girls with ADHD may experience symptoms as more socially oriented (e.g. losing track of thoughts in a conversation), non-disruptive (e.g. doodling) and internalised (e.g. feeling frustrated) than those described by current diagnostic criteria. Theme two highlights the importance of social impacts of ADHD on friends, home and school. Theme three describes the desire to ‘fit in’ socially, behaviours and strategies used to mask symptoms and associated unfavourable consequences. Theme four highlights variability in symptoms across different environmental contexts.ConclusionsThis study suggests that the presentation of ADHD symptoms in girls may be socially oriented, internalised and especially influenced by the social context. Also, female ADHD symptoms may be less visible due to scaffolding, masking and context. Future research should consider whether current ADHD diagnostic criteria require adjustment, to aid earlier recognition and diagnosis of ADHD in children and young people, especially in females
Do ingredients matter? Exploring consumer preference for abstract vs. concrete descriptors of plant-based meat and dairy alternatives
Get PDFIt is widely accepted that reducing the consumption of animal-based products bodes well for improving planetary and human health. Plant-based meat and dairy alternatives (PBMDAs) can contribute to this transition. How products are described is an important mechanism in enhancing their appeal. Product descriptors of PBMDAs vary in abstraction, ranging from indicating the absence of animal-based ingredients (e.g., meat-free burger) to identifying the presence of plant-based ingredients (e.g., plant-based burger) to highlighting the primary ingredient (e.g., lentil-based burger). Considering this, the study explored how British consumers (n=1073) rationalise abstract to concrete product descriptors and how this influences appeal, taste, health, and sustainability expectations. Many consumers find PBMDAs most appealing when described with high levels of abstraction, by simply describing the product as meat-or dairy-free. Similarly, the mentioning of explicit ingredients can carry pre-existing connotations. While appeal for PBMDAs differed significantly by abstraction, this variation was less pronounced in taste expectations, and even less so in terms of health and sustainability expectations. This implies that manufacturers can leverage abstract product descriptors for more flexibility in product formulation. Additionally, it helps integrate economical, functional and underused substitutes, including food by-products and novel proteins, which may not otherwise have widespread appeal
Access Repository Dashboard
Do you manage Open Research Online? Become a CORE Member to access insider analytics, issue reports and manage access to outputs from your repository in the CORE Repository Dashboard! 👇